Recommendations for the standards of equipping of the Bariatric and Metabolic Surgery Center.

INTRODUCTION: The prevalence of obesity in Poland and worldwide is constantly rising. High effectiveness of bariatric surgery has been proven in literature. It is recommended that bariatric procedures should be done by highly qualified surgeons with the appropriate, up-to-date medical equipment. AIM: The purpose of the study is to establish Polish recommendations and standards for the use of medical equipment for bariatric surgery centers. MATERIALS AND METHODS: The review of the present recommendations of the worldwide organizations and societies (including EAES, IFSO, SAGES) and guidelines was made. On the basis of current literature and authors's clinical experience we proposed standardized protocol for bariatric surgical equipment. CONCLUSIONS: Relevant equipping of bariatric surgery centers and implementation of standardized perioperative and surgery protocols will result in significant improvements in bariatric treatment. This will ensure patients safety, a shorter length of hospital stay and considerably reduce the risk of morbidity. Moreover, it will contribute to the efficacy of the bariatric and metabolic surgery procedures, in accordance with the highest globally accepted standards.

Evaluation of the Surgery Wound Healing Process Using Self-Adaptive Skin Suture or Mechanical Stapler.

UNLABELLED: Wound healing is a complex and time-phased process. The occurrence of numerous negative conditions as well as external factors have a significant influence on the risk of potential complications. Preparing the patient for surgery, attention should be paid to a number of factors determining the proper healing process. The aim of the study was to compare the results of the early period of surgical wound healing process with access via laparotomy using techniques, which are self-adaptive sutures and mechanical staplers used for skin closure. MATERIAL AND METHODS: The study included 120 patients divided into three groups, according to the degree of wound continence, in accordance with the CDC (Center for Disease Control and Prevention). Exclusion criteria based on objective analysis were applied for patients with a higher risk of complications. In all cases the skin layer was closed with monofilament suture or single-patient use stapler. A ten-day observation of the wound healing process was implemented. The study was randomized. RESULTS: In the case of patients groups identified as a "Clean Wound" and " Clean / Infected Wound" no significant differences were discovered. In the group "Contaminated/Infected Wound" significantly higher percentage of wound-healing complications were reported (p < 0.05) for which monofilament sutures was used. CONCLUSIONS: The study showed, that mechanical stapler is recommended for contaminated/infected surgical wounds due to significantly lower risk of complications. In the case of wounds divided as a "Clean" and "Clean/Infected" type of suturing material has no significant effect on wound healing.